The University of Mississippi Medical Center (UMNIC) proposes to establish a large-scale demonstration project to assess the effectiveness of Mississippi's methods of collecting and using information to reduce medical errors and their impact. Ten sites throughout Mississippi, all of which share the same system for reporting of medication errors and, for several academic and administrative functions, report to UMMC's Vice Chancellor for Health Affairs, will participate in this project. The goals of this project are threefold: (1) identify the causes of preventable heath care errors and patient injury in health care delivery; (2) develop, demonstrate, and evaluate strategies for reducing errors and improving patient safety throughout Mississippi; and (3 ) disseminate the results of the project's research and the strategies developed throughout the health care industry. The demographics of Mississippi's population, and specifically those individuals who employ the services of the ten study sites included in our proposal, focus heavily on the priority areas and populations of AHRQ. Specifically, these include inner-city areas, rural areas, low- income groups, minority groups, women, children, and the elderly. In order to achieve the stated goals, four specific aims have been identified. These are: (1) fostering a confidential, non-punitive environment for reporting the information to be collected in the proposed project; (2) identifying the root causes of medication use variances; (3) developing strategies to improve levels of patient safety, including improvements in administration systems, reporting mechanisms, and education programs for both health care providers and the consumers of health care services; and (4) disseminating the results of the research, increasing the awareness of health care providers and consumers of health care of their role in improving patient safety, and implementing systematic changes to effect positive outcomes.